Individual
NICOLE RAE MARISCAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
17042 BELLFLOWER BLVD, BELLFLOWER, CA 90706-5950
(562) 991-1324
Mailing address
17042 BELLFLOWER BLVD, BELLFLOWER, CA 90706-5950
(562) 991-1324
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4453
CA
Other
Enumeration date
09/08/2018
Last updated
09/08/2018
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